Radiology Billing Services in California

California's radiology practices face unique billing challenges shaped by Blue Shield of California / Anthem's commercial rules, Medi-Cal requirements, and Noridian Medicare policies. Our AAPC-certified coders specialize in both CA payer rules and radiology coding complexity.

AAPC Certified
CA Payer Expert
Radiology Specialists
2.49% Rate
110,000+CA Physicians
2.49%Starting Rate
5Medicaid MCOs
98%+Clean Claim Rate

Why California Radiology Practices Need Specialized Billing

California's healthcare market includes 110,000+ physicians, and radiology practices here face a payer market dominated by Blue Shield of California / Anthem on the commercial side and Medi-Cal on the public payer side. Medicare claims are processed through Noridian, which applies its own Local Coverage Determinations that directly affect radiology procedure coverage and medical necessity requirements. Generic billing teams without CA specific knowledge leave revenue on the table.

Radiology billing itself is complex. Radiology coding requires understanding of professional (mod 26) vs technical (mod TC) component billing, contrast administration rules (with/without/both), and the complex coding for interventional radiology procedures. When you combine this coding complexity with California's specific payer rules, authorization requirements, and 5 Medi-Cal managed care plans that each have their own billing rules, you need a team that understands both dimensions. Go Medical Billing provides that expertise at 2.49% of collections, serving radiology practices from Los Angeles to Oakland and across California.

Top CPT Codes for Radiology in California

Our CA coders handle these radiology codes daily, applying Noridian Medicare rules and Blue Shield of California / Anthem commercial policies to each claim.

Code
Description
71046
Chest X-ray
74177
CT Abdomen
70553
Brain MRI
76700
Abdominal US

California Payer Challenges for Radiology

Every CA payer has specific rules for radiology claims. Here's how we navigate them.

Blue Shield of California / Anthem Radiology Claims

Blue Shield of California / Anthem processes the largest share of California commercial radiology claims. We know their CA specific fee schedules, prior authorization requirements for radiology procedures, and their appeal timelines when claims are denied. 26/TC splits must match the service your practice actually provides.

Medi-Cal Radiology Billing

Medi-Cal routes radiology patients through 5 managed care plans: LA Care, Health Net, Molina, and 2 more. Each MCO has its own radiology authorization and billing rules that we manage.

Medicare (Noridian) Radiology Coverage

Noridian processes Medicare radiology claims in California with its own Local Coverage Determinations. We navigate Noridian's policies around contrast rules to prevent medical necessity denials.

Denial Prevention for California Radiology

Common radiology denials in California include 26/tc splits must match the service your practice actually provides and with contrast, without contrast, and with+without have different codes and rates. Our team catches these issues before submission and appeals aggressively with CA payer-specific documentation when denials occur.

Get Expert Radiology Billing in California

Free billing assessment for your CA radiology practice. See where revenue is leaking.

98%+ clean claim rate
2.49% starting rate
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What We Handle for California Radiology Practices

Diagnostic radiology coding (X-ray, CT, MRI, US)
Professional/technical component billing
Interventional radiology coding
Contrast protocol coding
Prior authorization for advanced imaging
Multi-modality practice billing

California Radiology Billing Cost Comparison

Hiring an in-house biller with radiology expertise in California costs $50K-$70K annually in salary alone. Add benefits, software, clearinghouse fees, and office space, and the true cost is even higher. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified radiology coders and CA payer specialists for a fraction of that cost.

$50K-$70K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

Frequently Asked Questions

All major CA payers: Blue Shield of California / Anthem, Kaiser, Health Net, Aetna, Cigna, UHC, Medi-Cal (including LA Care, Health Net, Molina), and Medicare through Noridian. If a payer accepts radiology patients in California, we submit and follow-up on claims with them.
The most frequent radiology denials we see from CA payers include 26/tc splits must match the service your practice actually provides, with contrast, without contrast, and with+without have different codes and rates, ir procedures combine surgical and imaging codes with specific supervision requirements. Our team catches these before submission by applying both radiology coding expertise and CA payer-specific rules to every claim.
Medi-Cal routes radiology patients through 5 managed care plans: LA Care, Health Net, Molina, Anthem, CalOptima. Each MCO has its own radiology authorization requirements, fee schedules, and billing rules. We credential and bill with all of them so your radiology practice gets paid correctly.
Most CA radiology practices are fully transitioned within two to three weeks. We connect to your EHR, learn your radiology workflows, and start submitting claims to Blue Shield of California / Anthem, Medi-Cal, Medicare, and all your CA payers with no downtime.

Fix Your California Radiology Billing

Call 888-701-6090 for a free billing assessment specific to your CA radiology practice. We'll show you where revenue is leaking and how to fix it.